MedicalResearch.com Interview with:
Nelly Mauras, MD
Chief, Division of Pediatric Endocrinology,
Nemours Children’s Health System
Professor of Pediatrics
Mayo College of Medicine
MedicalResearch.com: What is the background for this study?
Response: Keeping blood sugars close to normal in young children with diabetes is often limited by parental fears of the risks of low blood sugars and impaired cognitive development. Dr. Nelly Mauras, at the Nemours Children’s Health System in Jacksonville FL, along with Dr. Allan Reiss at Stanford University are co-principal investigators of the Diabetes Research in Children Network, a 5-center consortium performing studies in children with diabetes, also including the University of Iowa, Washington University St Louis and Yale University.
The investigators recruited 144 children with type 1 diabetes who were 4-7 years old and performed brain imaging (MRIs), did special cognitive tests, and monitored blood sugars using continuous glucose monitors. These studies were repeated after 18 months, approximately 54 months and 74 months, to examine changes in the brain and compare the results with those of 70 children the same age who do not have diabetes.
MedicalResearch.com: What are the main findings?
Response: At 54 months, they observed detectable and persistent differences between the two groups in the volumes of different areas of the brain, as well as slower rate of brain growth. They also observed differences in the groups’ performance in vocabulary and memory tests. The greatest association of the differences is with hyperglycemia (high blood sugars). These results were presented at the 2019 American Diabetes Association meetings.
MedicalResearch.com: What should readers take away from your report?
Response: There are measurable differences in the brains of young children with type 1 diabetes vs. non-diabetic youth; these differences persist over 5-6 years of follow up; and they are largely related to high glucose concentrations. This suggests that T1 diabetes may be detrimental to the developing brain.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: We want to further investigate the possible mechanisms of these reported brain changes and to further explore if meticulous control of the blood sugars can revert some of these changes in children.
MedicalResearch.com: Is there anything else you would like to add?
Response: We do not yet know if these changes will eventually affect learning or behavior in a more significant way or if they are reversible. This information gives us further impetus to continue to work to find better ways to control T1 diabetes, including the use of modern diabetes technology.
Dr. Mauras has institutional device supply agreements for research projects as well as research support from Medtronic, NovoNordisk, Lifescan, and Johnson & Johnson.
A Longitudinal Study of Brain Growth by the Diabetes Research in Children Network (DirecNet),” presented at the American Diabetes Association’s® (ADA’s) 79th Scientific Sessions®
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